Suicide in the elderly 60 years of age and over in the south-east part of Serbia

Some previous investigations indicated that economic crisis (inflation in Serbia 1993/94) have great influence on increasing suicide rates in Serbia. After that suicide decreased, despite the war and bombing in 1999, specially among the elderly people. A total of 453 suicides were registered on the territory of south-eastern Serbia during 1995-2001 years. Of them 295 (65.1%) were aged over 60 years. Generally linear trends of suicide among both genders from 1995 to 2001 decreased, but the slope of decreasing was grater among males than among females. The highest rates among the both genders were registered in the years with the maximum number of suicides, but the linear trends of rates have statistically important correlation with time (r>0.5). Average annual suicide rate among males was 42.5, and among women it was 18.7. The highest average annual suicide rate among men was observed in the age group 75 years and over (93.3), and the lowest in the age group 65-69 (20.6). Among males, in the all age group linear trends of suicide rates decreased, with the highest slope among 75 years and over and the lowest among 65-69 years. The highest suicide rate among females was registered in age group 75 years and over (25.6), the lowest in the age group 65-69 (13.5). The linear trends are similar as among males: downward trend was observed among all aged groups, with the highest slope among women 75 years and over. The most common way of suicide among men was hanging up (63%), poisoning and by firearms. There were no statistical differences between way of suicide and age groups. The most frequent way of suicide among females was hanging up (55%), poisoning (25%) and drowning (12%). There were statistically significant differences in drowning between age groups, 70-74 and 75 and over (p<0.05), and between poisoning and age groups 60-64 years and 75 years and over. Poisoning and drowning are statistically more frequent among women than among men.     

Epidemic of suicide by hanging in Lithuania: does socio-demographic status matter?

OBJECTIVE: To analyse suicide by hanging, compared with other methods, by demographic and selected social factors in Lithuania, and to evaluate changes during 1993-1997, and 1998-2002. METHODS: Data on committed suicides were compiled from the Lithuanian Department of Statistics. Suicides were identified by the International Classification of Diseases (ICD): codes in ICD-9 E950-E959 and codes in ICD-10 X60-X84. These were categorized into seven groups by method of suicide. Particular attention was paid to suicide and self-inflicted injury by hanging, strangulation and suffocation (ICD-9: E953; ICD-10: X70). These data were analysed by gender, age, place of residence, education, and marital status. RESULTS: A total of 8324 suicides (6864 men and 1460 women) were committed during 1993-1997, and 7823 suicides (6455 men and 1368 women) during 1998-2002. Of all registered suicides in Lithuania during 1993-2002, hanging was the most common method. Over the period under investigation, hanging, in proportion to all other methods used to commit suicide, increased statistically significantly from 89.4% among men and 77.3% among women between 1993 and 1997 to 91.7% among men and 82.6% among women between 1998 and 2002. The most noticeable rise occurred among girls aged 10-19 years. The next most common methods among men were firearms and poisoning; among women, poisoning and jumping from high places were common methods. Hanging predominated in men, older people, rural residents and people with low levels of education. A logistic regression analysis showed that gender (odds ratio [OR]=2.4; 95% confidence interval [CI] 2.2-2.7), place of residence (OR=2.0; 95% CI 1.8-2.2) and education (OR=1.2; 95% CI 1.1-1.3), independently of other factors, had the strongest influence on the choice of hanging as the method of suicide between 1993 and 2002. Age had only a minor effect, and marital status had no significant effect on choosing hanging to commit suicide. CONCLUSIONS: Hanging is the most common method of suicide in Lithuania. The popularity of this highly lethal method may be one of the underlying causes for the high rate of committed suicides. Universal approaches to suicide prevention deserve serious consideration, especially challenging the social acceptability of hanging among men, older people, rural residents, and low educated groups of the population in Lithuania.     

Sociodemographic and geographic patterns of firearm suicide in the United States, 1989-1993

This study identified the sociodemographic and geographic patterns of using firearms to commit suicide in the United States. Data from the Mortality Detail Files (1989-1993) were analyzed using logistic regression. The adjusted odds of using firearms increased with age among men and decreased among women. Widowed men and married women had the highest odds of using firearms. The odds were highest among those without college education, in nonmetropolitan areas and in the East South Central and West South Central geographic divisions. The likelihood of using firearms to commit suicide varies significantly across sociodemographic and geographic subgroups of the US population and parallels patterns of gun ownership. The results of this study suggest that regional cultural factors play an important role in accounting for the differential rates in suicidal behavior involving firearms.     

Space-time distribution of suicide in Galicia, Spain [1976-1998]]

Objective: To study the space-time distribution of suicide in Galicia from 1976 to 1998, taking into account gender, age, season and method of suicide.Methods: For each sex crude and age-adjusted rates per province and age-specific rates per period (1978-84, 1985-91, 1992-98) were calculated. To estimate mortality risk and time trends in the municipalities, a Bayesian hierarchical model was used.Results: In the last few years mortality from suicide has increase considerably. Age-adjusted rates of 6 per 105 at the beginning of the study rose to 10 per 105 at the end. The increase was greatest among men. The higher rates were observed in the elderly, although in terms of time trends the highest increase occurred among adolescents and young adults. In both sexes the main method of suicide was hanging. Less common methods were jumping from a height and shooting. The greatest number of suicides took place during the spring and summer months. In terms of spatial distribution, a high number of suicides were committed in the province of Lugo; in the municipalities, mortality risk decreased from North to South and an inverse temporal trend was observed in both sexes. This differed from the space-time patterns of suicides committed using methods other than hanging.Conclusions: Suicide is an important health problem in Galicia not only because to its magnitude but also because of the increasing rates, especially among young people. Geographical and temporal analysis can identify priority areas where preventive policies should be implemented.     

Are seasonalities in suicide dependent on suicide methods? A reappraisal

In general, suicide frequencies peak in spring and early summer and depict a low in autumn and winter months. Suicide seasonality is a ubiquitous phenomenon; however, recent studies have indicated that it is related particularly to violent suicide methods. We investigated differences in suicide seasonalities by suicide methods using Swiss mortality data. The suicide data were extracted from the Swiss cause of death statistics and cover the period 1969-1994. In this period 37,518 suicides (ICD-8 codes 950-959) were registered in the mortality statistics. The data were analysed by the Edwards' method, which examines unimodal sinusoidal patterns in aggregated monthly data, and by spectral analysis with disaggregated monthly data. Overall, Swiss suicide data in 1969-1994 depict the expected pattern with a peak in May and June and a low in December. However, analyses by suicide methods show that there is no common pattern. Suicide seasonalities are absent or weak in some violent as well as non-violent methods (firearms, cutting, crashing, poisoning). Even if clearly present (hanging, drowning, jumping from high places, unspecified/other), the seasonalities show distinct patterns and cycles. Apart from sinusoidal patterns, there are also outliers: in overall data as well as in most method-specific data, the December frequencies fall more than 10% below the neighbouring months. The decrease of the frequencies culminates at Christmas/New Year and then returns to average levels. Hence, the seasonality of the overall Swiss suicide frequencies is but a compound seasonality. It largely depends on specific suicide methods and different cyclical dynamics.     

Comparative study about methods of suicide between Japan and the United States

BACKGROUND: Suicide is one of the most important public health issues in both Japan and the United States. This study is to clarify the differences in methods of suicide between the two countries, among various races within the United States, and between genders and age-groups. METHODS: Vital statistics mortality data and the estimated population in 1999 in Japan and in the United States were used. Age-adjusted mortality rates were calculated using the age-specific total population of Japan and the United States as a standard population. In addition, the proportionate distribution of suicide methods was calculated. RESULTS: Age-adjusted mortality rates from suicide in Japan were about 2 times higher for males and 3 times higher for females compared with the United States. The most common method among both genders in Japan was hanging, followed by jumping from a high place. In the United States, it was firearms among both genders, followed by hanging among males and drugs among females. For Asians in the United States, hanging was the method of choice for about half among both genders; hanging was the most common method for the age group of 40 years or more among males and for all age groups among females. Firearms were the method of choice for the 20-39 age group among males. CONCLUSIONS: Although the overall suicide rates among Asians in the United States were lower than Japan, the methods were similar to those in Japan.     

Suicide Among Young People in the Americas

PurposeTo examine suicide mortality trends among young people (10–24 years of age¹) in selected countries and territories of the Americas.MethodsAn ecological study was conducted using a time series of suicide mortality data from 19 countries and one territory in the Region of the Americas from 2001 to 2008, comprising 90.3% of the regional population. The analyses included age-adjusted suicide mortality rates, average annual variation in suicide mortality rates, and relative risks for suicide, by age and sex.ResultsThe mean suicide rate for the selected study period and countries/territory was 5.7/100,000 young people (10–24 years), with suicide rates higher among males (7.7/100,000) than females (2.4/100,000). Countries with the highest total suicide mortality rates among young people (10–24 years) were Guyana, Suriname, Nicaragua, El Salvador, Chile, and Ecuador; countries with the lowest total suicide mortality rates included Mexico, Venezuela, Cuba, and Brazil, and the U.S. territory of Puerto Rico. During this period, there was a significant increase in suicide mortality rates among young people in the following countries: Argentina, Chile, Ecuador, Mexico, and Suriname; countries with significant decreases in suicide mortality rates included Canada, Colombia, Cuba, El Salvador, and Venezuela. The three leading suicide methods in the Americas were hanging, firearms, and poisoning.ConclusionsSome countries of the Americas have experienced a rise in adolescent and youth suicide during the study period, with males at a higher risk of committing suicide than females. Adolescent and youth suicide policies and programs are recommended, to curb this problem. Methodological limitations are discussed.     

Violent death in a metropolitan county: II. Changing patterns in suicides (1959-1974).

Suicide rates in Cuyahoga County (metropolitan Cleveland) rose from 10.2 in 1958 to 12.5 per 100,000 populations in 1974 (23 per cent increase) with the greatest rise among nonwhite males (from 5.9 to 13.1, or 122 per cent). Increased rates were observed in both the city (19 per cent increase) and suburbs (35 per cent increase). Rates increased among young non-white and white adults of both sexes aged 15--34 years, but decreased slightly among adults aged 65 years and older. These findings are consistent with national trends. Alcohol was present in the blood of one-fourth of the individuals who were "dead on arrival," and at intoxicating levels in 20 per cent. There were increasing percentages of victims with positive blood alcohol and with intoxicating levels during the study period. White male victims in the city had significantly higher frequencies of such findings than their counterparts in the suburbs. The rates of suicide committed by firearms rose among all race-sex groups, with the greatest increase among city nonwhite males (2.1 to 7.7, or 267 per cent). Suicide by chemical agents (roughly one-half being barbiturates) increased in all groups except city nonwhite males, with the greatest increase among white males and suburban white females. Firearms among males and poisoning among females displaced asphyxia as the leading modes of suicide.     

2015—2019年云南省老年人自杀死亡流行特征分析

目的 描述云南省老年人自杀死亡水平及流行特征,为减少老年人自杀,促进健康老龄化提供依据。方法 利用2015—2019年人口死亡信息登记管理系统中的全省监测数据,对云南省老年人自杀死亡流行病学特征进行统计分析。结果 2015—2019年间云南省老年人报告自杀死亡率为25.02/10万～28.59/10万,标化自杀死亡率为25.29/10万～27.17/10万;历年老年男性自杀报告死亡率均高于女性,农村老年人自杀报告死亡率均高于城市;同年份之间,自杀报告死亡率随年龄增大而上升,80岁及以上男性的自杀死亡率最高(44.67/10万～57.81/10万);80岁及以上老年人自杀报告死亡率呈上升趋势,差异有统计学意义(APC=7.92%,P<0.05)。老年人自杀死亡案例的婚姻状况以已婚为主(67.21%),自杀方式以服用农药(55.86%)和悬吊(34.12%)为主。结论 自杀是云南省老年人伤害死亡的主要原因之一,应采取综合策略减少老年人自杀行为的发生。     

Current trends in youth suicide and firearms regulations

BACKGROUND: Despite numerous prevention initiatives, suicide remains the second leading cause of death in youth aged 10-19. One of the major prevention strategies is the introduction of restrictive firearms regulations. For example, Bill C-17 was enacted in 1991 to promote safer handling and storage of firearms through mandatory safety courses for all new gun owners. Examining the suicide rates subsequent to Bill C-17 may shed light on the possible benefit of these regulations as a solution to this major public health issue. Therefore, this paper examines the trends in youth suicide from 1979-1999 and the association with changes in the firearms act in 1991. METHODS: Age-specific suicide rates for youth between 15-19 years and rates by methods of suicide were calculated based on data from Statistics Canada for the years 1979-1999. Time series analyses were conducted. RESULTS: Although the overall rates did not change from 1979-1999 in youth aged 15-19, there was a substantial change in the methods used. In particular, the rates of suicide by firearms dropped from 60% to 22% while suicide due to hanging/suffocation increased from 20% to 60% in this age group over this period of time. CONCLUSION: These results suggest a possible association between changes in the firearms act in 1991 and the methods used by youth to complete suicide. However, the overall rates of suicides did not change over this same period. These trends underscore the need for broader prevention interventions that do not solely focus on methods of suicide but rather, their underlying causes.     

Geography of suicide in Taiwan: spatial patterning and socioeconomic correlates

In industrialised Western nations suicide rates tend to be high in inner city areas and socially fragmented neighbourhoods. Few studies have investigated spatial variations in suicide in non-Western settings. We estimated smoothed standardised mortality ratios (1999-2007) for suicide for each of the 358 Taiwanese districts (median population aged 15+: 27,000) and investigated their associations with area characteristics using Bayesian hierarchical models. The geographic distribution of suicide was similar in men and women; young people showed the greatest spatial variation in rates. Rates were highest in East Taiwan, a mostly mountainous rural area. There was no evidence of above average rates in large cities. Spatial patterns of method-specific suicide rates varied markedly, with solids/liquids poisonings showing the greatest geographic variation and hangings the least. Factors most strongly associated with area suicide rates were median household income, population density and lone-parent households. Spatial patterning of suicide in Taiwan differed from that observed in Western nations. Suicide prevention strategies should take into account unique local patterns.     

Suicides among older United States residents: epidemiologic characteristics and trends.

Suicide rates for elderly US residents decreased between 1950 and 1980, but have increased recently. We analyzed suicide mortality trends using national mortality data for the period 1980 through 1986. Suicide rates during this period increased for each 5-year age group over age 65. Elderly White males have the highest suicide rates and experienced a rate increase of 23%. The rate for Black males rose by 42%. Divorced males have the highest age-adjusted sex- and martial status-specific rates, and experienced a rate increase of 38% over the 7-year period. Suicide rates among older US residents vary by region of the country and are highest in the West. Rates increased in all regions except the Northeast. Fire-arms are the most common method of suicide in the elderly, and firearm use increased during this period from 60% to 66% of all suicides. Given the recent increase in suicide rates for the elderly and the magnitude of the problem in this age group, it is again important to direct our attention to the problem of suicide in the elderly and recognize the need for effective prevention strategies.     

Suicide among nursing home residents: a population-based study

OBJECTIVE: The rate of suicide is highest among the oldest old and is associated with chronic medical illness and functional impairment. These risk factors are prevalent among nursing home (NH) residents, yet little has been published on suicide in this population. METHODS: We performed a population-based, retrospective cohort study to identify clinical features of NH residents attempting or completing suicide. A computerized data-base search was conducted to identify cases of completed suicide in Olmsted County and surrounding communities (846 NH beds) between 1981 and 1997. Subjects' medical records were reviewed to identify clinical details. RESULTS: Five cases of completed suicide and three suicide attempts were identified, including six men and two women. Deaths were the result of drowning, hanging, or medication overdose (the latter following a period of intentional hoarding). Those who died ranged in age from 69 to 87 years. Most had been NH residents for less than 6 months. No deaths occurred in patients with severe cognitive impairment. CONCLUSIONS: Suicide and suicide attempts in the NH seem to be uncommon but are likely underrecognized and underreported. Suicide risk among NH residents seems to be highest among men and those recently admitted to facilities. In addition, suicide methods differ among NH residents compared with community-dwelling older people, likely reflecting environmental restrictions and physical limitations. Suicide and suicide attempts are important resident health issues and risk management concerns for staff in long-term-care facilities.     

Suicide rates across income levels: Retrospective cohort data on 1 million participants collected between 2003 and 2013 in South Korea

Background

The relation of income and socioeconomic status with suicide rates remains unclear. Most previous studies have focused on the relationship between suicide rates and macroeconomic factors (e.g., economic growth rate). Therefore, we aimed to identify the relationship between individuals' socioeconomic position and suicide risk.

Socioeconomic indices and suicide rate in Queensland

Abstract: Suicides identified from a suicide register were classified according to socioeconomic indices of statistical local areas. Suicide rates were correlated with socioeconomic disadvantage, as measured by the proportion of persons of low income, low education and high unemployment living in an area. Suicide rates were inversely related to the proportion of families on high income, who owned their homes and who had large houses. Suicide rates of older people (55 years and over) were least influenced by these factors. For females, only the most disadvantaged areas had higher suicide rates. In other age and sex groupings, relationships were mostly linear.     

Socioeconomic differences in suicide mortality by sex in Finland in 1971-2000: a register-based study of trends, levels, and life expectancy differences

AIM: Suicide is a common cause of death in many Western countries and it has been predicted to become even more common worldwide. The authors analysed socioeconomic differences and trends in Finnish suicide mortality, and assessed the relevance to public health by calculating socioeconomic differences in years of life expectancy lost attributable to suicide. DATA AND METHODS: Census records were used, linked with the death records of men and women aged 25 years and over in 1971-2000 in Finland. RESULTS: Suicide among male and female manual workers was 2.3 and 1.3 times higher respectively than among upper non-manual workers. The differences were largest among those in their thirties. Because of the decline in suicide among upper non-manual workers and a slower decrease or even an increase among other socioeconomic groups, the relative mortality differences increased somewhat during 1970-90, then decreased in the 1990s but remained higher than in the 1970s. In 1991-2000 the suicide-related life expectancy gap between the upper non-manual and manual male workers was 0.6 years, and this difference contributed 10% to the total difference in years of life expectancy lost between these socioeconomic groups. CONCLUSION: Large and persistent socioeconomic differences were found in suicide mortality and suicide was an important component of the socioeconomic difference in total mortality. Reducing these differences could significantly improve equity in health and reduce the burden of excess mortality.     

Effects of socioeconomic factors on suicide from 1980 through 1999 in Osaka Prefecture,Japan

Suicide rate in Japan surged in 1998. Although the standardized mortality ratios (SMRs) of suicide in Osaka Prefecture, Japan had been mostly lower than the national SMRs of suicide between 1980 and 1997, they surpassed the increased national SMR of suicide in 1998 and 1999. We investigated whether the suicide rates for 1980-97 and the recent increased suicide rates in Osaka Prefecture were associated with socioeconomic factors. Time-series regression analyses of the suicide rate and socioeconomic factors were performed on respective data for five sub-areas in Osaka Prefecture. The suicide rates of young people and middle-aged men were more strongly associated with the job application and divorce rates for 1980-99 than for 1980-97. Some relations between the suicide rate and public assistance rate were found. The suicide rate was negatively associated with the marriage rate in some areas. The suicide rate of elderly women was strongly associated with the number of persons per household. The notable relation was found between the suicide rate of middle-aged men and the job application rate for 1980-99. The inverse relation between the suicide rate of elderly women and the number of persons per household was noteworthy.     

Lethality of firearms relative to other suicide methods: a population based study

OBJECTIVES: (1) To quantify lethality of firearms relative to other suicide methods, (2) to quantify the extent to which suicide mortality may be reduced by limiting access to firearms. METHODS: Data on suicides and hospitalised para-suicides that occurred in the state of Illinois from 1990 to 1997 were combined. Total number of episodes for each suicide method was estimated as the sum of the number of suicides and the number of para-suicides for that method. Gender and suicide method were used as proxies for intention to die, and estimated lethality of suicide methods within method-gender groups (for example, male firearm users). Logistic regression was used to quantify the lethality of firearms relative to other suicide methods. Excess mortality associated with the use of firearms was estimated by conservatively assuming that in the absence of firearms the next most lethal suicide method would be used. RESULTS: From January 1990 to December 1997, among individuals 10 years or older in the state of Illinois, there were 37,352 hospital admissions for para-suicide and 10,287 completed suicides. Firearms are the most lethal suicide method. Episodes involving firearms are 2.6 times (95% CI 2.1 to 3.1) more lethal than those involving suffocation-the second most lethal suicide method. Preventing access to firearms can reduce the proportion of fatal firearms related suicides by 32% among minors, and 6.5% among adults. CONCLUSIONS: Limiting access to firearms is a potentially effective means of reducing suicide mortality.     

Methods of suicide among persons aged 10-19 years--United States, 1992-2001

In 2001, suicide was the third leading cause of death among persons aged 10-19 years. The most common method of suicide in this age group was by firearm (49%), followed by suffocation (mostly hanging) (38%) and poisoning (7%). During 1992-2001, although the overall suicide rate among persons aged 10-19 years declined from 6.2 to 4.6 per 100,000 population, methods of suicide changed substantially. To characterize trends in suicide methods among persons in this age group, CDC analyzed data for persons living in the United States during 1992-2001. This report summarizes the results of that analysis, which indicated a substantial decline in suicides by firearm and an increase in suicides by suffocation in persons aged 10-14 and 15-19 years. Beginning in 1997, among persons aged 10-14 years, suffocation surpassed firearms as the most common suicide method. The decline in firearm suicides combined with the increase in suicides by suffocation suggests that changes have occurred in suicidal behavior among youths during the preceding decade. Public health officials should develop intervention strategies that address the challenges posed by these changes, including programs that integrate monitoring systems, etiologic research, and comprehensive prevention activities.